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June 3, 2020

The Search for a Uniformly Effective Treatment in Patients With Lupus Miliaris Disseminatus Faciei

Author Affiliations
  • 1Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • 2Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
JAMA Dermatol. Published online June 3, 2020. doi:10.1001/jamadermatol.2020.1069

Lupus miliaris disseminatus faciei (LMDF) is an uncommon inflammatory granulomatous dermatosis with possible immune mechanisms, affecting adults between the second and fourth decades of life.1 It presents with multiple asymptomatic, erythematous to yellow-brown papules on the central part of the face and eyelids. Histopathologic test results show perifollicular epithelioid granulomas with caseous necrosis, although a sarcoid granuloma–like appearance has also been reported.2 A few researchers consider LMDF to be a variant of granulomatous rosacea or an inflammatory response to Demodex folliculorum and/or Propionibacterium acnes.1 Although the disease resolves spontaneously within 1 to 2 years, it produces cosmetically disfiguring scars on the face. Treatment response has been unsatisfactory; multiple agents—including tetracyclines, corticosteroids, and isotretinoin—have been tried, with no single uniformly effective treatment.

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